Treatment of Thyroid Disorders
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Type 1 Diabetes Treatment
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Dr. Gopala Krishnam Raju Ambati provides answers that are very helpful.
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Dr. Gopala Krishnam Raju Ambati provides answers that are very helpful.
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Women tend to develop high levels of blood sugar during their pregnancy (especially within the 24th and 28th weeks), irrespective of whether they already had suffered from diabetes prior to their pregnancy. However, gestational diabetes, if not taken proper care of, might escalate the risks of developing diabetes in the near future for both the mother and the child, accompanied by complications in pregnancy or labor. Gestational diabetes is usually characterized by mild symptoms such as excessive urge to urinate, excessive thirst, blurred vision and fatigue.
Insulin, a hormone produced by the pancreas, allows for the utilization of the glucose for energy. The food consumed is broken down by the digestive tract of the body, converting carbohydrates into glucose before releasing it into the bloodstream. The glucose is then absorbed by the cells to be used as an energy source. Now, at the time of pregnancy, the placenta (organ nourishing the fetus) connecting the baby to the blood supply also produces various other hormones in high levels, for instance, estrogen and human placental lactogen. Most of these hinder the normal functioning of insulin in the cells, hence raising the blood sugar count. With subsequent growth of the baby, the placenta keeps on producing more amounts of such insulin resistant hormones to an extent that they are capable of meddling with the development of the baby.
1. Monitoring the blood sugar count at least four to five times a day and keeping it under control might help to ease the complication.
2. A healthy diet consisting of whole grains, vegetables and fruits in the right proportion and limiting sugar or other highly refined carbs meets the nutrition and fiber requirement of the body. Guard against additional weight gain during pregnancy as that hampers the entire process.
3. Exercise or regular physical activities help to normalize blood sugar level by boosting glucose absorption in the cells. Furthermore, exercises also enhance the sensitivity of the cells towards insulin. This means that only a little amount of insulin production by your body would be enough for the transportation of sugar.
4. Medication, If exercise and diet fall inadequate, insulin injections are often administered to control blood sugar count.
5. Keeping the baby under close observation with the help of repeated ultrasound and other tests to record its growth and development is an essential part of the treatment plan.
One of the most common scenarios that most people are faced with is a constant feeling of tiredness and lethargy even after you have had a full night’s sleep. The questions popping in your mind right about now is, why is this happening? Why does the lethargic feeling fail to leave you even after you had a proper 8 hours sleep? Why is your sleep getting into the way of your professional productivity? Though there are a number of different explanations to this constant feeling of cloudiness throughout the day, hence, experts in the field have listed down some of the factors that prove to be the major causes behind this condition.
Some of these most common and powerful reasons are listed below.
- Thyroid: The moment your thyroid levels start soaring, you will automatically find it difficult to keep up with the pace that your day to day life demands. The thyroid gland, which is placed right in front of the throat, is the size of the knot on your tie. This gland produces a hormone. When the activity of the thyroid gland, it starts secreting more and more of the hormones, leading to a condition termed as hyperthyroidism. The same gland when underperforms, it starts holding back the hormone secretion, leading to a condition called hypothyroidism. In both the cases the metabolism of the body slows down, leading to an increased level of tiredness even after proper sleep.
- Anaemia: Another leading cause of that nagging feeling of sleepiness and draining energy is Anaemia. Anaemia causes a certain amount of fatigue in an individual. The main cause influencing this situation is the lack of presence of enough red blood cells. The main function of these red blood cells is to transfer oxygen constantly from the long to the cells and tissues. A break in this process leads to you feeling weak and also short of breath.
- Diabetes: Diabetes poses a serious threat to the all over functioning of your body. It is termed as the slow killer and constantly works towards undermining the level of energy a normal individual can hold. This adversely affects your day to day life, including your performance at work and also performing your daily chores at home. The glucose in your body serves as a fuel for your daily activities. Since patients with type 2 diabetes cannot use this rising glucose in their blood properly, they end up being more tired than they ought to be.
Other conditions that lead to the same draining feeling and constant tiredness even after lot of sleep are depression, rheumatoid arthritis, chronic fatigue, sleep apnea, sleep inertia, periodic limb movement disorder, constant exposure to computer screens, tv screen, monitors, etc. There are a whole bag of other factors that lead to the constant feeling of tiredness that you are feeling. Before the end of the day, you are drained, your productivity drops and you cannot wait to hit the bed, and the same is the condition when you get out of bed. Consulting a general physician will not only help you put a finger on the cause, but also cure it with proper treatment.
While it is well known that smoking causes lung cancer, heavy smokers with diabetes are also at increased risk of death from causes other than lung cancer, according to a study being presented next week at the annual meeting of the radiological society of north america (rsna).
Diabetes is a chronic illness in which there are high levels of glucose in the blood. More than 29 million people in the u. S. Have diabetes, up from the previous estimate of 26 million in 2010, according to a report released by the centers for disease control and prevention. One in four people with diabetes doesn't know he or she has it. Having diabetes can also put people at risk for numerous other health complications.
To determine the extent to which diabetes is associated with deaths from lung cancer, other cancers, and other causes among heavy smokers, researchers examined the risk for all-cause mortality among people with and without diabetes within the national lung screening trial (nlst), a massive, multicenter trial that compared low-dose helical ct with chest x-ray for early detection of lung cancer in current and former heavy smokers.
" in our study, we found a statistically significant link between diabetes and all-cause deaths, non-lung cancer deaths and lung cancer deaths in women" said kavita garg, m. D, professor of radiology from the university of colorado -- denver.
For the study, Dr. Garg and colleagues looked at data from 53, 454 participants in the nlst and identified 5, 174 participants who reported having diabetes at screening.
They conducted an analysis of the relative risk for overall mortality, lung cancer mortality, and non-lung cancer mortality associated with diabetes, adjusting for age, gender, body mass index (bmi), and pack-years of smoking. Over the course of the study, there were 3, 936 total deaths, including 1, 021 from lung cancer and 826 from cancers not of the lung.
Participants with diabetes tended to be older, reported more pack-years of smoking, and had a higher bmi than those without diabetes. There were 650 deaths (12.6 percent of patients) among participants with diabetes and 3, 286 deaths (6.8 percent of patients) among participants without diabetes.
" we found that diabetes doubles the risk for all-cause mortality and non-lung cancer mortality among heavy smokers" Dr. Garg said" we also found that women with diabetes have an increased risk of lung-cancer mortality, but did not find the same effect in men"
The researchers continue to analyze data in an effort to better understand the underlying cause. In the meantime, Dr. Garg emphasizes the importance of taking control of diabetes and undergoing lung cancer screening if you're a smoker.
" patients have to take care of their diabetes to maximize the benefit of ct screening for lung cancer" she said" it truly makes a magnitude of difference in mortality risk"
Diabetes mellitus is a group of diseases where the body does not adequately produce insulin, use insulin properly, or both. Insulin plays a crucial role in allowing blood sugar into the cells to be used for energy. There are two main types: type 1 and type 2 diabetes.
A woman running in the park with her dog
Staying healthy by exercising and eating well is recommended for people with diabetes.
People with diabetes have abnormally high levels of blood sugar. This can damage many organs in the body if left untreated. The national institute of diabetes and digestive and kidney diseases recommend the following steps to manage diabetes:
Make healthy choices in eating
Engage in regular physical activity or exercise
Take medications, if required.
Healthy eating is important in keeping blood sugar levels at a healthy level. The healthy range is 80 to 130 mg/dl before meals or below 180 mg/dl after meals, according to the american diabetes association.
People with type 1 diabetes require insulin. Various insulin delivery systems and protocols are used to manage blood sugar both between and at meal times.
People with type 2 diabetes often manage their condition with diet and exercise, and with medications as needed to keep blood sugar within the target range. These medications vary in how they work.
People with diabetes will have different treatment plans, and they will respond to food, exercise, and medication differently.
It is important to consult with a doctor to get individualized recommendations on target blood sugar levels, medications, diet, and exercise.
How do carbohydrates affect diabetes?
Carbohydrates are an important source of energy for the body. Carbohydrates are found in foods that have starches and natural or added sugars. Examples are grains, vegetables and legumes, fruit, dairy products, and sweets.
Carbohydrates are broken down by the digestive system into sugar. When the digested sugar enters the blood, the body produces a hormone called insulin. Insulin helps the sugar enter cells. Once the cells absorb the sugar, blood sugar levels fall.
People with diabetes have an impaired ability to produce insulin, use insulin, or both.
People with type 1 diabetes cannot produce insulin, so they take insulin to make sure the cells can get the sugar they need for energy.
People with type 2 diabetes are often insulin resistant. They also often have difficulty producing enough insulin to keep their blood sugar in the normal range.
Carbohydrate counting is a way of keeping track of the carbohydrates in the daily diet. A person with diabetes who uses carbohydrate counting to manage their diet sets an amount of carbohydrate to eat for meals and snacks.
Foods containing carbohydrates
Bread, pasta, rice, and potatoes are all sources of carbohydrates.
The american diabetes association suggest a target of about 45 to 60 grams of carbohydrate per meal. This recommendation may vary depending on other factors such as gender, weight goals, and blood sugar target goals.
The three different types of carbohydrates are starch, sugar, and fiber.
Starches are complex carbohydrates found in starchy vegetables such as peas, potatoes, and corn. Beans and whole grains are also complex carbohydrates.
Fiber comes from plants and cannot be digested. Fiber is found in foods such as vegetables, fruit, whole grains, legumes, and nuts.
Unlike other carbohydrates, fiber does not raise blood sugar, and it can help to slow the digestion of meals. This helps to minimize spikes in blood sugar. It is recommended to eat between 20 to 35 grams of fiber per day.
Sugar is a carbohydrate. It is generally absorbed into the body more quickly. There are natural sugars found in milk and fruit. There may also be added sugars in canned fruits, baked goods, and processed foods.
There are also carbohydrates in non-starchy vegetables such as lettuce, peppers, cucumber, mushrooms, and many others. There are fewer carbohydrates in these foods because they have a high water content. For example, a half cup of cucumber has around 2 grams of carbohydrate.
The type and amount of carbohydrate will affect post-meal blood sugar levels.
Foods that digest more slowly, such as those with a lot of fiber, and those eaten as a mixed meal, digest more slowly. They can help to prevent post-meal spikes in blood sugar. Large amounts of carbohydrates eaten at one time will raise blood sugar more than smaller amounts.
Is eating rice healthy with diabetes?
High-carbohydrate foods like grains, cereals, pasta, rice, and starchy vegetables are not forbidden, but they should be eaten in moderation.
Rice is a high-carbohydrate grain, but it can be incorporated into meals in appropriate amounts.
One-third of a cup of rice has 15 grams of carbohydrate. That accounts for one-fourth to one-third of the amount of carbohydrate recommended for a single meal, if the target is 45-60 grams of carbohydrate per meal.
Meals that also include healthy proteins and fats can help to slow the impact of the rice on blood sugar levels.
Are some types of rice healthier than others?
Some grains are better than others for managing diabetes.
A scale called the" glycemic index" measures how quickly food is digested into sugar and absorbed in the blood. High glycemic foods raise blood sugar faster and should be eaten in limited portions, or eaten with lower glycemic index foods.
White rice is more processed and it has a higher glycemic index than brown rice, although the index of brown rice can vary with type and brand.
Different varieties of rice have different glycemic indexes. Some long grain rice varieties, converted rice, and basmati rice varieties are lower on the gi scale than white rice.
Puffed rice cereal and rice cakes are sometimes thought of as diet foods, but they have a high glycemic index and they are not ideal for healthy meals.
Foods that are high in fiber offer many health benefits. They help with blood sugar control, they promote bowel health, and they may lower cholesterol.
Whole grains have more fiber than other grains. It is important to check the label to check the fiber content.
Tips for preparing rice
Some brown rice varieties are unprocessed and have more fiber. They can be part of a balanced meal when eaten in proper portions. Mixing brown rice with other foods can help to balance blood sugar levels. Examples include legumes, such as red beans, or protein and healthy fats.
A bowl of brown rice
Brown rice may have a lower glycemic index than white rice.
Brown rice takes longer to cook than white rice, but the cooking process is simple. People can cook brown rice in a pot or rice cooker at a ratio of 1.5 cups of water per 1 cup of rice.
The instructions are as follows:
Bring rice and water to a boil in an uncovered pot
Cover the pot and simmer for about 20 minutes
Turn off heat and let the covered pot sit for at least 10 minutes.
Rice can be mixed with seasonings, herbs, vegetables, and nuts such as slivered almonds.
Brown rice can be stored in a refrigerator and used for leftovers. People can reheat brown rice on the stove or microwave and serve with beans and salsa for a quick meal.
Care must be taken with storage, because cooked rice left at room temperature can develop toxins that lead to food poisoning.
Nutritious and delicious alternatives to rice
Because rice is high in carbohydrates, it should be accompanied by other foods.
Vegetables are high in fiber, vitamins, and other nutrients. Vegetables are made of carbohydrates, but at a much lower level than grains.
Eating foods that are lower in carbohydrates and higher in fiber can make meals more satisfying. For example, one-half cup of rice has 22 grams of carbohydrate. In contrast, one cup of squash only has 8 grams of carbohydrate.
Many foods can serve as substitutes for rice.
Examples include cauliflower, mushrooms, and eggplant. Quinoa contains the same amount of carbohydrates as rice, but it has more protein, and some types have more fiber.
Recipes for rice substitutes
A number of recipes are available for rice substitutes. Here are two examples:
1. Cauliflower" rice"
Pulse the florets of a cauliflower in the food processor. Then heat the cauliflower in a pan with oil and onions. Saut until the onions are golden brown and the cauliflower is soft for about 3 to 5 minutes.
Season to taste with salt, pepper, lemon juice, and herbs.
Full recipe from the food network.
2. Cilantro lime quinoa
Low-sodium chicken broth
Juice of limes
Saut the onion and garlic with oil in a skillet. Reduce the heat and stir in the quinoa. Stir quinoa and cook for 2 minutes. Add chicken broth and lime juice and bring to a boil. Then reduce heat and simmer for 15 minutes. Stir in more lime juice and add chopped cilantro.
I am male 54 years of age, weight 61 kg/height-5'8" My fasting blood sugar level varies between 145-220 since last 2 years. I am not taking any medicine except patanjali Madhunashini 2 tabs twice a day. I am not feeling any specific problem like frequent urinating, weight gain etc. My father was also a diabetic patient. My diet is normal and I am non-veg. My physical activity is very less. I walk approx. 2-3 km few times a week Please advice some medicine and diet plan so that I could control my sugar level. Thanking You.
Dr. I have hyperthyroidism for last 5 years I am taking regular treatment for that and my thyroid is in control but still I have problem with night sleep. That means I do not get sufficient sleep at night. Regards,
Mixup also reveals knowledge gaps in handling insulin
An order was written for a hospitalized patient for 90 units of insulin glargine (lantus). The hospital normally used insulin pens, but the pens can only dial up to a dose of 80 units. Therefore, the pharmacy dispensed a 10 ml vial of lantus. The nurse caring for the patient was inexperienced and had only used pens before, so she was unfamiliar with drawing up doses of insulin into a syringe. When the nurse looked at the vial label, it may have been turned slightly so that all she saw was 100 units with a 10 directly under it. This is a different label presentation than on more familiar lantus vials (figure 1, left).
The confusing vial label represents a change that was made last year. The pictured vial has a march 2019 expiration date. The nurse assumed the concentration was 100 units/10 ml and then proceeded to draw up 9 ml into a 10 ml syringe and injected 900 units of lantus subcutaneously as a single 9 ml dose. (the maximum volume for a subcutaneous injection is generally 2 ml.) the results could have been catastrophic. But within a couple of hours, the nurse realized her mistake and reported it. The patient was immediately given a dextrose infusion and, fortunately, did not suffer harm.
(familiar lantus label on the left and confusing lantus label [more recent] on the right.)
In addition to the nurse's lack of knowledge about insulin administration, safe dosing, and the maximum volume per subcutaneous injection, one of the contributing factors of this event was the formatting of the lantus vial label. The 10 is directly beneath the 100 units. this contrasts with the formatting of the lantus box, which has one 10 ml vial, so the 10 is not directly beneath the 100. Other obvious contributing factors include unfamiliarity with drawing up insulin from a vial, not understanding the meaning of a u-100 concentration, and not using a u-100 insulin syringe, which was available on the patient care unit.
All this notwithstanding, it must be said that the best way to avoid such errors is for pharmacy to prepare, label, and dispense patient-specific basal insulin doses. Also, it's surprising how many insulin-related errors reported to us reveal knowledge gaps in handling insulin. Thus, it is critical to educate staff as necessary regarding injection technique and how to measure doses with insulin syringes. We notified sanofi and the u. S. Food and drug administration (fda) about the labeling issue that contributed to a misunderstanding of the concentration.